Manor Field Surgery Blog Number 8 – Pain

This is not a blog that will cover the entire topic of pain and pain management (the ‘proper’ name for helping pain).

Just some simple tips.

Nothing fancy.

Pain is one of the most common reasons for a patient seeking medical advice. It also plays a major role in the progress of all sorts of diseases and conditions, in other words, sometimes the pain is the thing, and at other times it is an outcome of the thing.

Part of the problem with pain is that it is necessary.

Take it away, either physical or emotional and we would come to major harm or worse, stop being human.

Pain is part of what it is to be alive and it is the quest to minimise or reduce pain that is behind much of our behaviour. (Driven by dopamine – for another day).

The most common form of pain that people in Maltby, and, indeed, anywhere in the UK experience is that associated with arthritis; osteoarthritis to be specific. This is a still poorly understood condition of pain associated with wearing-out of the protective, cushioning cartilage that sits between our bones at joints and changes to the bone itself.

As we age, everyone develops this to a greater or lesser extent.

Weirdly, some people with severe arthritis don’t experience any discomfort and others with what is sometimes called ‘mild’ have terrible pain.

That is one of the complicating aspects – pain is both relative (a sore knee after walking vs scalding your hand with boiling water) and personal – my pain is my pain and only I can understand it – although we clinical folk try to empathise, we can never know what someone else is experiencing.

Enough of the psychobabble, what can be done?

Well, putting it very simply, you can either stop doing what is causing the pain – if you are a runner with a bad ankle, rest. Or, if rest is not an option, say, you have pain every time you move, there are three things to do.

First, like the runner, rest. Easier said than done, although if you can avoid certain activities that allow the pain to settle, perhaps asking someone to give you a hand or using a stick to relief the pressure on the painful area, that can help.

Second, if you can’t rest or rest doesn’t seem to make any difference, you can give it a rub.

I know that sounds a little unsophisticated ‘rub’ – it is however based in sound science that acknowledges when you (or someone else) rubs a painful area – back, shoulder, neck, this both releases pain relieving hormones and affects how you experience the pain.

It can be quite pleasant too, to have someone give you a rub.

This can be more effective if the rub turns into a massage with say an anti-inflammatory cream or something more natural like coconut oil.

Again, this doesn’t always work; no matter how hard or long you or someone else rubs.

Third, we then enter into the area of medicine.

Taking tablets, pills and potions.

This in itself is a minefield, mainly, and, unfortunately, because you venture into the world of the ‘Pharma-Industrial Complex’ as doctor and writer, Seamus O’Mahony describes the sometimes naughty/manipulative/underhand machinations of the pharmaceutical industry.

‘Buy this drug, it works 5% better than that one’ (but costs twice as much) kind of thing.

I will stick with Paracetamol (Acetaminophen if you are American), as, to my mind, this tends to be the safest medicine (although of course, when taken in excess can be deadly).

If you have one-off, what is likely to be short-lived pain, taking a couple of Paracetamol often does the trick. It has, as far as I am aware the least side effects of any painkiller and is also very effective.

If the pain is more constant, like that bad knee that is there every day, all day, taking regular Paracetamol can be much more effective – for an average adult, this is two tablets four times a day – we have learned recently, for those who weight less than 50Kg, this should only be one tablet four times a day.

I guess if this doesn’t work and the pain shows no sign of improving, see a doctor or nurse, although given that what I am suggesting is essentially self-help, I am equally not saying that people can’t continue to help themselves.

Most pain is mild and settles with rest and time, some is chronic and requires longer-term support and some is serious – when new, unexpected or unexplained (this is when you really should see the doctor).